1. Field of the Invention
The present invention relates to an endoscope system, an endoscope, and a supporting member that are provided with a moving mechanism for moving in a lumen an endoscope insertion portion inserted in the lumen, and a method of using the endoscope system.
2. Description of the Related Art
In recent years, there has been performed so-called ERCP (Endoscopic Retrograde Cholangiopancreatography), in which a region to be inspected in a canaliculus in a body cavity, i.e., in a lumen, that is, the region to be inspected in a pancreaticobiliary duct system for example is inspected and treated using a side-view endoscope including an image pickup optical system disposed on a side surface of a distal end of an insertion portion.
The ERCP using the side-view endoscope (hereinafter called simply as endoscope) includes, in addition to an inspection such as cholangiography and pancreatography by a treatment instrument like a catheter, a therapeutic treatment by collecting gallstones in the common bile duct or the like with the treatment instrument such as a balloon or a basket.
In addition, in performing the ERCP, a technique is required for insertion of a treatment instrument such as catheter (hereinafter called simply as treatment instrument) into the bile duct or the pancreatic duct, since the pancreatic duct and the bile duct are very narrow ducts.
Therefore, normally in inserting a treatment instrument into the bile duct or the pancreatic duct, a distal end of an endoscope insertion portion is first inserted to near the duodenum papilla, and therefrom, under the observation of the endoscope, field of view of an endoscope is ensured by adjusting a distance between the papilla and the distal end of the endoscope insertion portion by advancing/retreating operation, bending operation, or the like of the endoscope itself.
After that, by pushing-in operation of the treatment instrument from a proximal end side of a treatment instrument insertion conduit provided inside of the insertion portion, the treatment instrument is projected from an aperture portion of the treatment instrument insertion conduit formed on a side surface of the distal end of the insertion portion and the projected treatment instrument is inserted into the bile duct and the pancreatic duct through the papilla.
Note that in inserting the treatment instrument into the bile duct or the pancreatic duct from a distal end aperture portion of the treatment instrument insertion conduit, it is well-known that an insertion angle can be fine-tuned by using a so-called treatment instrument raising table (hereinafter called simply as raising table) which is provided in the vicinity of the distal end aperture portion.
Incidentally, as described above, the pancreatic duct and the bile duct are very narrow ducts. Therefore, when insertion of the treatment instrument into the bile duct or the pancreatic duct by push-in operation is difficult even with the use of the raising table, it is necessary to perform advancing/retreating operation, bending operation, or the like of the endoscope itself again so as to bring the endoscope close to the papilla.
However, if the advancing/retreating operation, bending operation or the like of the endoscope itself is performed again, the field of view direction is changed. Therefore, it is necessary to perform adjustment to secure the field of view of the endoscope again. In addition, particularly, if bending operation is performed in left/right direction with respect to the papilla, the projecting direction of the treatment instrument projecting from the distal end aperture portion and the direction of the bile duct, for example, are deviated from each other to left and right, thereby causing a difficulty in insertion of the treatment instrument. As a result, an operator needs to adjust the projecting direction of the treatment instrument and the direction of the bile duct again, which is a cumbersome work for the operator.
Note that, in the side-view endoscope, the raising table adjusts the treatment instrument in up/down direction with respect to the papilla after securing the field of view, so that the raising table cannot coincide the projecting direction of the treatment instrument and the direction of the bile duct which are deviated from each other to left and right.
In addition, in a case of insertion of the treatment instrument using the raising table, a tendency to bending is given to the treatment instrument from the raising table, as the treatment instrument undergoes several cases. As a result, there is a problem that insertion of the treatment instrument into the bile duct or the pancreatic duct by push-in operation becomes difficult due to the tendency to bending.
In view of such a problem, in a moving mechanism disclosed in Japanese Unexamined Patent Application Publication No. 2004-97391, for example, three balloons contactable with inside of the lumen are provided on an outer circumference of a distal end portion which is located on a side nearer to the distal end side than a bending portion in the endoscope insertion portion and each of the balloons is inflated and contracted in a state where three balloons are inflated to contact inside of the body cavity, thereby enabling a distal end side of an endoscope insertion portion to move in a lumen in parallel with respect to a field of view direction of the endoscope while securing the field of view of the endoscope, without the advancing/retreating operation, bending operation or the like of the endoscope itself after securing the field of view of the endoscope.
Note that the moving mechanism in the present publication is applied to a direct-view endoscope in the publication. However, if the moving mechanism is applied to a side-view endoscope, it is possible, after securing a field of view of an endoscope, to bring a distal end portion of the endoscope close to a region to be inspected in a lumen while securing the field of view of the endoscope, thereby facilitating the insertion of the treatment instrument into the bile duct or the pancreatic duct.
Furthermore, Japanese Unexamined Patent Application Publication No. 2000-342528 discloses a technique to facilitate the insertion of the treatment instrument into the bile duct or the pancreatic duct. In the technique, on an outer circumference of a distal end portion, on which a treatment instrument insertion conduit is open, located on the side nearer to the distal end than the bending portion of the insertion portion of the side-view endoscope, a circumferential balloon covering the outer circumference is provided, and after the field of view of the endoscope is secured, the circumferential balloon is inflated to contact the inside of the body cavity and enables the distal end portion of the endoscope to be fixed in the body cavity.